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      AEROBIC FITNESS, MUSCULAR STRENGTH, AND OBESITY IN RELATION TO RISK OF HEART FAILURE

      research-article
      , M.D., Ph.D. 1 , 2 , , M.D., Ph.D. 1 , 3 , , Ph.D. 4 , , M.D., Ph.D. 1 , 3
      Heart (British Cardiac Society)
      body mass index, heart failure, muscle strength, obesity, physical fitness

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          Abstract

          Objective:

          Low physical fitness and obesity have been associated with higher risk of developing heart failure (HF), but their interactive effects are unknown. Elucidation of interactions among these common, modifiable factors may help facilitate more effective primary prevention.

          Methods:

          We conducted a national cohort study to examine interactive effects of aerobic fitness, muscular strength, and body mass index (BMI) among 1,330,610 military conscripts in Sweden during 1969–1997 (97–98% of all 18-year-old males) on risk of HF identified from inpatient and outpatient diagnoses through 2012 (maximum age 62 years).

          Results:

          There were 11,711 men diagnosed with HF in 37.8 million person-years of follow-up. Low aerobic fitness, low muscular strength, and obesity were independently associated with higher risk of HF, after adjusting for each other, socioeconomic factors, other chronic diseases, and family history of HF. The combination of low aerobic fitness and low muscular strength (lowest vs. highest tertiles) was associated with a 1.7-fold risk of HF (95% CI, 1.6–1.9; P<0.001; incidence rates per 100,000 person-years, 43.2 vs. 10.8). These factors had positive additive and multiplicative interactions ( P<0.001), and were associated with increased risk of HF even among men with normal BMI.

          Conclusions:

          Low aerobic fitness, low muscular strength, and obesity at age 18 were independently associated with higher risk of HF in adulthood, with interactive effects between aerobic fitness and muscular strength. These findings suggest that early-life interventions may help reduce the long-term risk of HF and should include both aerobic fitness and muscular strength, even among persons with normal BMI.

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          Author and article information

          Journal
          9602087
          20297
          Heart
          Heart
          Heart (British Cardiac Society)
          1355-6037
          1468-201X
          7 August 2019
          12 May 2017
          November 2017
          13 August 2019
          : 103
          : 22
          : 1780-1787
          Affiliations
          [1 ]Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
          [2 ]Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
          [3 ]Center for Primary Health Care Research, Lund University, Malmö, Sweden
          [4 ]Stanford Prevention Research Center, Stanford University, Stanford, CA, USA
          Author notes

          Author Contributions:

          Dr. Jan Sundquist had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

          Study concept and design: Crump, J. Sundquist, Winkleby, K. Sundquist.

          Acquisition of data: J. Sundquist, K. Sundquist.

          Analysis and interpretation of data: Crump, J. Sundquist, Winkleby, K. Sundquist.

          Drafting of the manuscript: Crump.

          Critical revision of the manuscript for important intellectual content: Crump, J. Sundquist, Winkleby, K. Sundquist.

          Statistical analysis: Crump, J. Sundquist.

          Obtained funding: J. Sundquist, K. Sundquist.

          Corresponding author: Casey Crump, M.D., Ph.D., Icahn School of Medicine at Mount Sinai, Departments of Family Medicine and Community Health and of Population Health Science and Policy, One Gustave L. Levy Place, Box 1077, New York, NY 10029, USA. Tel: (212) 659-1471. Fax: (212) 659-9071. casey.crump@ 123456mssm.edu
          Article
          PMC6691361 PMC6691361 6691361 nihpa1044843
          10.1136/heartjnl-2016-310716
          6691361
          28500243
          bf36f8e3-7232-4a7a-8565-f5bbc519d7fa
          History
          Categories
          Article

          physical fitness,obesity,muscle strength,heart failure,body mass index

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